The journal *Archives of Internal Medicine* issued the following news release:

Insomnia often appears to be a persistent condition

About three-fourths of individuals with insomnia report experiencing the
condition for at least one year and almost half experience it for three
years, according to a report in the March 9 issue of Archives of
Internal Medicine, one of the JAMA/Archives journals.

Insomnia is the inability to fall asleep or stay asleep. “Approximately
30 percent of adults report symptoms of insomnia and 6 percent to 10
percent meet diagnostic criteria for an insomnia disorder,” the authors
write as background information in the article. Several factors such as
being female, increasing age, having anxiety or depression and
experiencing pain from medical conditions have been associated with
insomnia. The condition has been linked to higher health care costs,
work absenteeism, disability and higher risk of hypertension and depression.

Charles M. Morin, Ph.D., of Universite Laval and Centre de recherche
Universite Laval–Robert Giffard, Quebec, Canada, and colleagues
evaluated insomnia persistence, remission and relapse in 388 adults
(average age 44.8) over a course of three years. Individuals with an
insomnia syndrome (insomnia symptoms at least three nights per week for
at least one month causing substantial distress or daytime impairment)
at the beginning of the study (n=119) were compared to those with
insomnia symptoms (n=269) to examine the course of initial severe sleep
difficulties.

“Of the study sample, 74 percent reported insomnia for at least one year
and 46 percent reported insomnia persisting over the entire three-year
study,” the authors write. The group with initial insomnia syndrome had
a higher persistence rate than the group with symptoms of insomnia (66.1
percent vs. 37.2 percent), respectively. About fifty-four percent of
participants went into insomnia remission; however, 26.7 percent of them
eventually experienced relapse. “Individuals with subsyndromal insomnia
[insomnia symptoms] at baseline were three times more likely to remit
than worsen to syndrome status, although persistence was the most
frequent course in that group as well,” the authors note.

Of the 269 individuals with baseline symptoms of insomnia, after one
year 38.4 percent were classified as good sleepers, 48.7 percent still
had insomnia symptoms and 12.9 percent had insomnia syndrome. Results
were similar after the second and third year of follow-up. Of the 119
participants with insomnia syndrome at the beginning of the study, 17
percent were good sleepers after one year, while 37 percent had symptoms
of insomnia and 46 percent remained in the insomnia syndrome group.

“This study provides preliminary evidence to better understand the
natural course of insomnia. Additional studies are needed, however, to
identify moderating and mediating factors of persistence, remission and
relapse,” the authors conclude. “Improved understanding of the long-term
course of persistent insomnia would be helpful to guide the development
of effective public health prevention and intervention programs to avert
long-term negative outcomes.”

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